4 Ways Gastroenterology Practices Can Boost Profitability

Gastroenterology practices today are under immense pressure from the combination of declining reimbursement and rising costs. Among other recent challenges, CMS’s dramatic cuts to the 2014 Medicare reimbursement rates for upper GI endoscopy services dealt a tough blow to gastroenterologists across the country.

The stress of running a practice in this environment is naturally taking a toll, with nearly 2 in 5 gastroenterologists experiencing burnout.1 With the extra demands on gastroenterologists’ time and declining reimbursement, “everybody feels like they are running harder to stay where they are,” explains Dr. Rowen Zetterman, Gastroenterologist/Hepatologist and Dean of the Creighton School of Medicine.2

Never ones to shy away from difficult challenges, gastroenterologists and their staff are proactively seeking new ways to boost profitability in the face of these external pressures. Below, learn about four key moves that are helping gastroenterology practices boost their bottom lines.

1 Medscape Gastroenterologist Compensation Report 2014.2 Cynthia H. Starr, “Gastroenterologists’ Compensation: Still a Great Way to Make a Living,” Medscape, Jan. 28, 2014.3 Medscape Gastroenterologist Compensation Report 2014.4 Cynthia H. Starr, “Gastroenterologists’ Compensation: Still a Great Way to Make a Living,” Medscape, Jan. 28, 2014.

1. Raising the Top Line with New Revenue Streams

Faced with declining reimbursements for their core procedures,

gastroenterologists are finding new ways to raise their total

revenue potential. One key new source of revenue is ancillary

services. According to Medscape research, more than 1 in 3

gastroenterologists in private practice now enhances revenue

with ancillary services such as ambulatory surgical services, in-

house infusion, lab work, and imaging.3

Dr. Lawrence Kosinski, Managing Partner at the Illinois Gastroenterology Group and former Chair of the

American Gastroenterological Association’s Practice Management & Economics Committee, explains,

“If you’re fortunate enough to own your own ambulatory surgical center (ASC), you can probably

double your income. If you add your own pathology laboratory, you can earn even more.” He adds, “By

moving our procedures out of the hospital to ASCs that we own and run, we not only garner the facility

fee for ourselves, we also improve efficiency because we can do more procedures in the same period

of time than we could at the hospital.”4

2. Improving Collections Through Outsourcing

The top two drivers of burnout for gastroenterologists are “too many bureaucratic tasks” and “spending

too many hours at work,” according to a 2013 Medscape survey, so it’s no wonder that they are looking

to outside partners to take on some of the most critical, cumbersome tasks for their practices.5 In an

interview with Becker’s ASC Review, gastroenterologist Dr. W. Travis Dierenfeldt reported that two key

steps he’s taken to adapt to industry change and prepare for the future are buying an electronic health

record system (EHR) and outsourcing billing and HR to third parties.6

Outsourcing revenue cycle management can help gastroenterology practices both improve collections

and free up time, as the vendor handles key financial tasks that are complicated and time-consuming

(e.g., appealing denials, contacting payers about claims without responses). Without outside support,

many practices end up leaving revenue on the table, as an estimated 65% of practices don’t appeal

denied claims.7 With the right partner and software, gastroenterology practices can both increase their

chances of getting paid the first time around and ensure that they’re dealing with denials optimally, two

key contributors to profitability.

3. Billing More Effectively with Modern Software

Medical practices across specialties have focused on

EHRs in recent years, but the growing complexity around

healthcare reimbursement has put a new spotlight

on practice management systems. Outdated, clunky

systems limit how quickly billers can get claims out

the door and many lack key features that help reduce

5 Medscape Gastroenterologist Lifestyle Report 2013.6 Carrie Pallardy, “Healthcare Consolidation & the Solo GI Physician: Q&A With Gastroenterologist Dr. Travis Dierenfeldt,” Becker’s ASC Review, Jan. 7, 2014.7 Madeline Hyden, “Insurance denials: Is your practice to blame?” MGMA In Practice blog, Dec. 21, 2011.

Gastroenterology practices nationwide are embracing

the benefits of cloud-based practice management

and EHR systems. In addition to providing access to

patient records from wherever gastroenterologists

are providing care—in the office, hospital, or

ambulatory surgery center—the cloud also helps

them reduce IT costs.

The cloud eliminates the costs of buying or

renting on-site servers—and the stress around

keeping them functional and secure—and lets

gastroenterology practices replace hefty licensing and maintenance fees with predictable, pay-as-you-

go pricing. What’s more, not only does the cloud reduce existing costs, but it also supports practice

growth long-term since adding new sites or providers simply requires setting up logins – not additional

servers. At a time when IT costs continue to rise, the cloud offers gastroenterology practices a way to

reverse the trend.

denials, such as built-in billing rules. Profitability always takes a hit from denials: practices either have

to re-work claims at an average cost of $25 per claim or sacrifice revenue.8

The switch to ICD-10 threatens to make a bad denials situation worse, further fueling the replacement

trend. In fact, a 2014 Software Advice study found that the top two reasons buyers are replacing their

PM systems are lack of confidence around ICD-10 readiness and their current system being outdated.9

A modern PM system can help gastroenterology practices plug drains on profitability—today and when

ICD-10 goes into effect in 2015.

4. Cutting Costs with the Cloud

8 Tina Graham, “You might be losing thousands of dollars per month in 'unclean' claims,” MGMA Connection, Feb. 2014.9 Software Advice, Medical Practice Management Software BuyerView 2014.

While challenges abound, gastroenterologists still find much to be grateful for and excited about in

their profession—from the diverse nature of the conditions they treat to the satisfaction that comes with

solving tough cases. In fact, just over half of gastroenterologists would choose medicine again and

almost 60% would choose the same specialty. Dr. Kosinski affirms, “it’s still a wonderful profession” and

Dr. Zetterman exerts, “it’s a great field.”10

With more control over the financial health of their practices and less worry about future viability,

career satisfaction would undoubtedly rise for gastroenterologists and their staff. And, while there’s

no magic solution, the four steps above provide a promising path for gastroenterology practices to

achieve higher profitability and greater peace of mind.

Conclusion

CareCloud is a leading provider of cloud-based practice management, electronic health record (EHR) and medical billing software and services for medical groups. The company’s products are connecting providers to one another – and to their patients – through a fully integrated digital healthcare ecosystem that can be accessed on any browser or device.

CareCloud is helping thousands of physicians to increase collections, streamline operations and improve patient care in over 48 states and currently manages over $3 billion in annualized accounts receivables on behalf of its revenue cycle management clients.

1-877-342-7519 – hello@carecloud.com

10 Medscape Gastroenterologist Compensation Report 2014.

Learn more about CareCloud’s powerful software and services for gastroenterology practices at www.carecloud.com/gastroenterology